A panic attack is a “false alarm” in the brain. Our brains are hardwired to respond instantaneously, releasing everything we have physically and mentally in moments of crisis. Heroic stories of people lifting cars off of loved ones are examples of this.

In a panic attack we suddenly react physiologically, but there is no crisis. These attacks come “out of the blue.” Because there is no precipitating event, we wonder, “what’s wrong, am I dying, having a heart attack, or going crazy”?

Just as Pavlov conditioned dogs to salivate to a bell, a panic attack becomes conditioned to the environment in which the attack occurred. Anticipatory fear of having another attack can cause anxiety.

There is also a tendency to want to avoid or have great anxiety about situations or places where the panic attacks have occurred. Agoraphobia, or literally “fear of the market place,” is more specifically fear of panic attacks.

I always check the political cartoons-they can say so much in so few words. This past weekend Kirk Walters captured the drama of the recent earthquake in the Toronto Blade. He shows a giant tidal wave (labeled NATURE), and three little sandcastles on the beach (labeled MAN).

We begin 2005 somewhat shell shocked by this sudden massive natural disaster, one of the most destructive in recorded history. Almost overnight everyone knows what a tsunami is. There is no better time to reflect on the ultimate questions.

We are reminded again how vulnerable we are and how awesome are the powers of nature; hurricanes, earthquakes, fires. After millions of years of dominating our planet, dinosaurs were wiped out fairly quickly, supposedly as a consequence of a giant asteroid. But we are just as vulnerable to microorganisms. Bacteria and viruses reproduce many times a day. Each time random mutations provide opportunities to be better adapted. Their chance of survival is enhanced by resistance to our treatments.

Obviously, there is no way to guarantee safety for ourselves and our loved ones. We can wear seat belts and develop good health habits but many things are beyond our control.

As we learn more and more about the science of nature we also learn about what we don’t know. Socrates said that his greatest wisdom was his awareness of his ignorance.

In the face of this recent tragedy, I am thankful to be among the survivors. I have to remind myself to be more in the present, to not worry about the things I can’t control and to value each moment with family and friends. I appreciate being in great health. I appreciate that I live in a country where I am free. I believe I have been given many gifts which bring with them responsibilities. I’m glad. I literally thank God for my life and yet I know the next tsunami may have my name on it!